Abstract
Chronic pain is characterized by a dysfunction of the central nervous system. Central and peripheral sensitization are mechanisms that contribute to this dysfunction, which can cause a patient to perceive pain despite the absence of stimulation. Effective treatment of chronic pain is challenging because of this complex pathophysiology. Furthermore, current treatment options are limited by their adverse effects due to off-target actions and lack of anatomic specificity. This has created a growing need for customized therapy for the individual patient, and our increased understanding of genetics with the development of new, innovative technologies have made personalized medicine a feasible option. In this chapter we explore the application of personalized medicine in the form of gene- and cell-based therapies and its role in chronic pain management.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Basbaum AI, Bautista DM, Scherrer G, Julius D. Cellular and molecular mechanisms of pain. Cell. 2009;139:267–84.
Campbell JN, Meyer RA. Mechanisms of neuropathic pain. Neuron. 2006;52:77–92.
Chattopadhyay M, Mata M, Fink DJ. Vector-mediated release of GABA attenuates pain-related behaviors and reduces Na(V)1.7 in DRG neurons. Eur J Pain (London, England). 2011;15:913–20.
Dabbagh A, Rajaei S. Opium abuse and its problems in anesthesia practice: a review from bench to bedside. J Cell Mol Anesth. 2016;1:78–86.
Eaton M. Cell therapy for neuropathic pain in spinal cord injuries. Expert Opin Biol Ther. 2004;4:1861–9.
Furlan AD, Sandoval JA, Mailis-Gagnon A, Tunks E. Opioids for chronic noncancer pain: a meta-analysis of effectiveness and side effects. CMAJ. 2006;174:1589–94.
Gangadharan V, Kuner R. Pain hypersensitivity mechanisms at a glance. Dis Model Mech. 2013;6:889–95.
Goins WF, Cohen JB, Glorioso JC. Gene therapy for the treatment of chronic peripheral nervous system pain. Neurobiol Dis. 2012;48:255–70.
Hino M, Ogata T, Morino T, Horiuchi H, Yamamoto H. Intrathecal transplantation of autologous macrophages genetically modified to secrete proenkephalin ameliorated hyperalgesia and allodynia following peripheral nerve injury in rats. Neurosci Res. 2009;64:56–62.
Huh Y, Ji RR, Chen G. Neuroinflammation, bone marrow stem cells, and chronic pain. Front Immunol. 2017;8:1014.
Li WW, Guo TZ, Liang DY, Sun Y, Kingery WS, Clark JD. Substance P signaling controls mast cell activation, degranulation, and nociceptive sensitization in a rat fracture model of complex regional pain syndrome. Anesthesiology. 2012;116:882–95.
Meeus M, Nijs J. Central sensitization: a biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome. Clin Rheumatol. 2007;26:465–73.
Nasseri BNV, Manaheji H, Mousavi Z, Zaringhalam. Microglia are involved in pain related behaviors during the acute and chronic phases of arthritis inflammation. J Cell Mol Anesth. 2016;1:137–45.
Noble M, Treadwell JR, Tregear SJ, Coates VH, Wiffen PJ, Akafomo C, Schoelles KM. Long-term opioid management for chronic noncancer pain. Cochrane Database Syst Rev. 2010;2010:Cd006605.
Orozco L, Soler R, Morera C, Alberca M, Sanchez A, Garcia-Sancho J. Intervertebral disc repair by autologous mesenchymal bone marrow cells: a pilot study. Transplantation. 2011;92:822–8.
Portenoy RK. Current pharmacotherapy of chronic pain. J Pain Symptom Manag. 2000;19:S16–20.
Riley J, Boulis NM. Molecular mechanisms of pain: a basis for chronic pain and therapeutic approaches based on the cell and the gene. Clin Neurosurg. 2006;53:77–97.
Sahbaie P, Shi X, Guo TZ, Qiao Y, Yeomans DC, Kingery WS, Clark JD. Role of substance P signaling in enhanced nociceptive sensitization and local cytokine production after incision. Pain. 2009;145:341–9.
Siddall PJ. Neuroplasticity and pain: what does it all mean? Med J Aust. 2013;198:177–8.
Subedi B, Grossberg GT. Phantom limb pain: mechanisms and treatment approaches. Pain Res Treat. 2011;2011:864605.
Taghizadeh M, Manaheji H, Baniasadi M, Mohammadi M, Zaringhalam J. Immune and opioid system interaction in pain modulation. J Cell Mol Anesth. 2019;4:24–30.
Talebi Z, Dabbagh A. Perioperative pain: molecular mechanisms and future perspectives. J Cell Mol Anesth. 2017;2:134–41.
Toblin RL, Mack KA, Perveen G, Paulozzi LJ. A population-based survey of chronic pain and its treatment with prescription drugs. Pain. 2011;152:1249–55.
Vaquero J, Zurita M, Rico MA, Aguayo C, Bonilla C, Marin E, Tapiador N, Sevilla M, Vazquez D, Carballido J, Fernandez C, Rodriguez-Boto G, Ovejero M. Intrathecal administration of autologous mesenchymal stromal cells for spinal cord injury: safety and efficacy of the 100/3 guideline. Cytotherapy. 2018;20:806–19.
Wolfe D, Hao S, Hu J, Srinivasan R, Goss J, Mata M, Fink DJ, Glorioso JC. Engineering an endomorphin-2 gene for use in neuropathic pain therapy. Pain. 2007;133:29–38.
Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011;152:S2–15.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Campbell, S., Pak, D. (2021). Personalized Medicine in Pain Management. In: Dabbagh, A. (eds) Personalized Medicine in Anesthesia, Pain and Perioperative Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-53525-4_6
Download citation
DOI: https://doi.org/10.1007/978-3-030-53525-4_6
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-53524-7
Online ISBN: 978-3-030-53525-4
eBook Packages: MedicineMedicine (R0)